title: Donor-derived filamentous fungal infections in solid organ transplant recipients.
abstract: OBJECTIVE
  Filamentous fungal infections due to rare opportunistic moulds can be transmitted with an allograft. However, epidemiologic and clinical characteristics of donor-derived filamentous fungal infections (DDFFIs) in transplant recipients are poorly understood. Hence, the aim of this article is to describe donor-related risk factors, clinical presentation, graft and recipient outcomes associated with DDFFIs.
  
  
  RESULTS
  To date, 23 cases of donor-derived opportunistic filamentous fungal infections have been reported; a majority (91%) occurred in kidney transplant recipients. Aspergillus spp. was the most common organism (71%). Risk factors for DDFFIs include immunosuppressive state of the donor (transplant recipients serving as organ donors), near-drowning events, and transplant-tourism practices. DDFFIs manifested as vascular complications related to graft vasculature (65%), allograft dysfunction (43%) and unexplained febrile illness (39%) in the recipient. Rates of graft loss and overall mortality were 83 and 17%, respectively.
  
  
  CONCLUSIONS
  Donor-transmitted filamentous mycoses have a unique spectrum of illness and clinical settings under which transmission occurs. Prompt recognition, early surgical intervention and specific antifungal therapy are necessary for achieving optimal graft and recipient outcomes.
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania 15240, USA.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Gomez
authors.forename: Nina
authors.initials: N
authors.lastname: Singh
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D006801:Humans; D009181:Mycoses / Q000209:etiology* / Q000517:prevention & control / Q000635:transmission; D016377:Organ Transplantation; D012307:Risk Factors; D014019:Tissue Donors
chemical_list: D000935:Antifungal Agents